Dementia diagnosis and treatment

Symptoms of dementia vary from person to person and depend on the type of dementia you have.

Mild symptoms are known as mild cognitive impairment (MCI) which may stay the same or get worse over time and develop into dementia. Early symptoms of dementia can be subtle and may not be immediately obvious.

Common symptoms of dementia may include: 

• Memory loss
• Confusion, particularly in relation to time and place 
• Changes in personality, behaviour, or mood 
• Difficulty concentrating
• Difficulty finding the right word or following conversations
• Depression 
• Anxiety 
• Difficulty performing familiar tasks

Dementia is not a single condition and what causes dementia depends on the type of dementia you have. 

Types of dementia include: 

• Alzheimer's disease — the most common type of dementia is thought to be caused by the build-up of two proteins in the brain called amyloid and tau
• Vascular dementia — this type of dementia occurs when the blood supply to your brain is reduced causing brain cells to die. Vascular dementia can be caused by narrowing or blocking of the small blood vessels in the brain, a single stroke, or a series of mini-strokes. 
• Dementia with Lewy bodies —this type of dementia is caused by tiny clumps of a protein called alpha-synuclein (Lewy bodies) clumping together inside brain cells. This damages the way brain cells work and communicate and eventually causes them to die.
• Frontotemporal dementia — This type of dementia is most common in people aged 45 to 65. It occurs due to abnormal clumping of proteins such as tau in the frontal and temporal lobes, causing brain cells to die and shrinkage of the affected parts of the brain.  
• Mixed dementia —a combination of more than one type of dementia is called mixed dementia. This is most commonly Alzheimer’s disease and vascular dementia but can be a combination of other types. 
• Other conditions — some other conditions that can cause dementia or dementia-like symptoms include severe depression and anxiety, thyroid problems, Huntington’s chorea, corticobasal degeneration (CBD), progressive supranuclear palsy (PSP), normal pressure hydrocephalus and Parkinson’s disease 
  
  
  

At your first consultation, you will be seen by a consultant neurologist, a doctor specialising in conditions affecting the brain, nerves, and spinal cord. Your consultant will ask you about your symptoms and any changes you have noticed in your memory, cognitive function, and ability to perform everyday tasks. They will also ask you about your general health, medical history, and any medications you are taking. 

It’s a good idea to take someone with you to your appointment, so they can tell your consultant about any changes they may have noticed. 

Your consultant may perform a physical examination and order tests such as a blood test to rule out any other conditions that could be causing your symptoms. 

Will I need tests or scans?

If other conditions have been ruled out, your consultant may order further tests such as cognitive assessments and brain scans.

Cognitive assessments

Dementia can be difficult to diagnose, especially in the early stages when symptoms are mild. Your consultant may perform a series of tests to assess your cognitive function. These are called cognitive assessments and usually involve a series of questions, each of which has a score.

The tests help your consultant to assess your: 

• Short and long-term memory
• Concentration and attention span
• Language and communication skills
• Awareness of time and place (orientation)

Cognitive assessments cannot diagnose dementia and the scores may be affected by other factors such as your educational level, but they can give your consultant an idea of your cognitive function and whether you need further investigations. 

Brain scans 

While brain scans cannot diagnose dementia, your consultant may order a CT or MRI scan to assess your brain for any abnormalities as well as rule out other conditions such as a brain tumour or stroke that could be causing your symptoms. It’s possible to have a normal brain scan and still have dementia. 

Types of scans may include: 

• Magnetic Resonance Imaging (MRI) scan — can help confirm a dementia diagnosis, identify blood vessel damage present in vascular dementia, and shrinkage in certain areas of the brain 
• Computerised Tomography (CT) scan — to check for other conditions such as a stroke or a brain tumour
• SPECT or PET scan — may be used if the result of your MRI or CT scan is inconclusive 

How is a diagnosis made?

Your consultant will make a diagnosis based on your symptoms and the results of any tests or scans. 

Why is this first consultation so important?

At Circle Health Group, your first appointment is important as it’s where your consultant will assess your symptoms, perform a physical examination, order any necessary tests, provide a diagnosis, and discuss possible treatments. 

Your first consultation is also where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your first appointment. 
After making a diagnosis, your consultant will discuss possible treatment options with you and decide on the best option based on your symptoms and diagnosis. 

There is no cure for dementia, but treatment aims to reduce your symptoms and slow the progression of the disease. 

Dementia treatment depends on the type of dementia you have and usually involves a combination of medication and therapies. 

Medication 

There are several different types of medications to treat dementia. Your consultant will decide on the best medication or combination of medications for you depending on your symptoms and the type of dementia you have. 

Acetylcholinesterase inhibitors

Acetylcholinesterase inhibitors (donepezil, rivastigmine, galantamine) are used to treat Alzheimer’s disease and may also help symptoms of dementia with Lewy bodies, some types of mixed dementia and dementia related to Parkinson’s disease. These medications work by preventing an enzyme called acetylcholinesterase from breaking down acetylcholine in the brain. Acetylcholine is a substance that helps nerve cells in the brain communicate and is reduced in people with Alzheimer’s disease. 

Memantine

Memantine (Ebixa, Marixino, Valios) can be used to treat moderate or severe Alzheimer's disease, dementia with Lewy bodies and patients with a combination of Alzheimer's disease and vascular dementia.

Memantine works by blocking the effects of a chemical called glutamate that helps communication between nerve cells in the brain. In people with Alzheimer’s, excessive amounts of glutamate are produced causing further damage to brain cells. It may be prescribed for people who cannot take or are unable to tolerate acetylcholinesterase inhibitors. 

Other medications

Other medications that may be prescribed for patients with dementia include:

• Antidepressants if depression or anxiety is suspected
• Aspirin and other medicines to reduce the risk of heart disease or stroke, particularly for those with vascular dementia.
• Sleeping tablets for patients with insomnia (sleep problems)
• Antipsychotics or  tranquillisers may be prescribed as a last resort for patients exhibiting severe agitation, aggression, or distress 

Other therapies 

There are many therapies that can be used alongside medication to help manage symptoms of dementia. The right therapy for you will depend on your symptoms and the impact they have on your life. 

Your consultant can recommend a suitable therapy or combination of therapies tailored to your individual needs. 

Cognitive stimulation therapy

Cognitive stimulation therapy (CST) may be recommended for patients with mild to moderate dementia. It involves small groups of five to seven people taking part in activities designed to encourage thought processes, improve memory and problem-solving and promote language use and social interaction. 

Cognitive rehabilitation

Cognitive rehabilitation involves one-to-one sessions with a practitioner to help patients with dementia identify and learn everyday tasks that are important to them. It works by encouraging you to use the parts of your brain that are working to help the parts that are not. Cognitive rehabilitation can make it easier to cope with the symptoms of dementia, particularly in the early stages. 

Reality orientation

Involves frequent reminders about people, times, and places. Reminders may be oral or written on a board in a prominent place. 

Regular physical activity

Regular activity such as walking, dancing or seated exercise may help to slow a decline in mobility as well as enhance your mood and help with symptoms of depression. 

Reminiscence and life story work

Reminiscence and life story work are two approaches that are often combined. Reminiscence work can be done as a group or one-to-one and involves discussing the past, often using stimuli such as music, pictures, or objects from the past. 

Life story work involves creating a compilation of items from your past to build a physical or digital “scrapbook” of your life events and achievements. 

Measures to stimulate memory and simplify your daily routine 

Involves actions such as planning and writing down a daily routine, writing reminders and making sure that frequently used items such as keys, medications or glasses are put in places where they can be found easily. It may also be useful to label frequently used objects to help remember their names. 

Animal-assisted therapy

Animal-assisted therapy may help people with dementia who exhibit challenging behaviour such as agitation or aggression. 

Cognitive behavioural therapy (CBT)

CBT may be used to help treat symptoms of depression, which is common in people with dementia.

Sensory stimulation

Stimulating the brain and senses using music, lights, sounds, smells, massage, and aromatherapy may be beneficial for some people with dementia and help to improve mood or feelings of restlessness.

Like all medications, medications for dementia can cause side effects in some people. Your consultant will discuss all the possible side effects with you and give you instructions on how to use your medication correctly. Follow these instructions carefully and ask your consultant or pharmacist if you have any questions. Most side effects are mild and usually improve within a few weeks. Talk to your consultant if you experience unpleasant side effects, or if your side effects are getting worse or not going away.

Common side effects of acetylcholinesterase inhibitors include:

• Feeling sick
• Fatigue
• Muscle cramps
• Headaches
• Dizziness
• Constipation
• Diarrhoea
• Loss of appetite
• Confusion

Common side effects of memantine include:

• Headaches
• Constipation
• Fatigue
• Dizziness

Non-medical therapies for dementia are safe and do not have any potential risks or complications.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including: 

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about dementia treatment, book your appointment online today or call a member of our team directly on 0808 189 5499.

Content reviewed by Circle in-house team in April 2024. Next review due April 2027.

• Dementia treatments Alzheimer's Society 
• What are the treatments for dementia? NHS
• What Is Dementia? Alzheimer’s Association  
• Medication and Treatment for Dementia Patient  
• Dementia National Institute for Health and Care Excellence (NICE)